Newly elected governors face questions on Medicaid

November 08, 2012

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The eleven governors who were newly elected or re-elected on Tuesday night will soon have to publicly affirm their positions on several Affordable Care Act provisions, such as the law's Medicaid expansion. Most of the gubernatorial candidates had hesitated to state their positions on the expansion until after the election.

As of Thursday morning, winners have been declared in all 11 gubernatorial races, with seven Democrats and four Republicans winning victories:

When the Supreme Court upheld the ACA in June, the justices ruled that states can opt out of the expansion without any effect on current funding, essentially leaving the final decision up to each state's governor. So far, Republican governors in six states—Florida, Georgia, Louisiana, Mississippi, South Carolina and Texas—have announced that they will not participate.

Under the ACA, the federal government would cover the full cost for the first three years of the expansion, which begins in 2016. However, analysts predict that the re-election of President Obama, coupled with intense lobbying by health advocates and the availability of billions of dollars federal subsidies, will persuade the six governors and other holdouts to move forward with the expansion and other provisions in the ACA, according to Kaiser Health News.

Kansas Insurance Commissioner Sandy Praeger, a former president of the National Association of Insurance Commissioners, said she expects states will try to negotiate more limited expansion options.

Paul Keckley, executive director of Deloitte’s Center for Health Solutions research group, said the Obama administration now also might be more willing to offer states more flexibility for some of the ACA provisions—or delay rolling out several of them—to ensure greater participation and success, Bloomberg reports.

Explore the strategic, financial, and operational implications for hospitals and health systems—and discuss the ongoing political debate about the future of health care reform and provider reimbursement that will continue well beyond the election.

Voters in three states on Tuesday approved ballot initiatives that block the implementation of the Affordable Care Act's individual mandate, while one state voted to block the establishment of a state-run insurance exchange.

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